Related Experiment Video
Updated: Aug 21, 2026
Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus
Published on: April 5, 2011
Inappropriate emergency management of status epilepticus in children contributes to need for intensive care
R F M Chin1, L Verhulst, B G R Neville
1Neurosciences Unit, Institute of Child Health, University College London, WC1N 1EH, UK. r.chin@ich.ucl.ac.uk
Insights
Status epilepticus (SE) in children admitted to pediatric intensive care (PIC) often involves inadequate pre-hospital treatment with benzodiazepines, increasing respiratory depression risk. Guidelines need review to ensure appropriate SE management and reduce intensive care admissions.
Area of Science:
- Pediatric critical care medicine
- Neurology
- Emergency medicine
Background:
- Status epilepticus (SE) is a critical neurological emergency in children.
- Understanding the characteristics of SE in pediatric intensive care (PIC) is crucial for optimizing treatment and reducing intensive care needs.
Purpose of the Study:
- To characterize the clinical features, pre-PIC emergency treatment, and outcomes of pediatric SE cases admitted to PIC.
- To identify factors contributing to PIC admission for SE and inform strategies for reducing intensive care requirements.
Main Methods:
- Retrospective, cross-sectional study of children (29 days to 15 years) with SE admitted to a tertiary pediatric intensive care unit over three years.
- Systematic review of case notes, extracting clinical, demographic, and treatment data.
Main Results:
- Most pediatric SE admissions to PIC were in children under 5 years, with similar male-to-female ratios.
- Prolonged febrile convulsions, CNS infections, and epilepsy were common causes of SE.
- Many children received more than two or inadequate doses of benzodiazepines, contrary to guidelines, increasing the risk of respiratory depression and insufficiency, especially with pre-hospital treatment.
Conclusions:
- Pre-hospital treatment of SE in children is often inadequate, necessitating a review of current guidelines.
- Clinicians must be aware of the increased risk of respiratory depression with excessive benzodiazepine use in SE management.
- Further research is needed to understand the long-term morbidity associated with pediatric SE requiring intensive care.
Objectives:
To characterise the clinical features, emergency pre-paediatric intensive care (PIC) treatment, and course of status epilepticus (SE) in children admitted to PIC. This may provide insight into reasons for admission to PIC and provide a framework for the development of strategies that decrease the requirement for intensive care.
Design:
Cross sectional, retrospective study.
Setting:
A tertiary paediatric institution's intensive care unit.
Participants:
The admission database and all discharge summaries of each admission to a tertiary paediatric institution's PIC over a three year period were searched for children aged between 29 days and 15 years with a diagnosis of SE or related diagnoses. The case notes of potential cases of SE were systematically reviewed, and clinical and demographic data extracted using a standard data collection form.
Results:
Most children with SE admitted to PIC are aged less than 5 years, male to female ratio 1:1, and most (77%) will have had no previous episodes of SE. Prolonged febrile convulsions, SE related to central nervous system infection, and SE associated with epilepsy occur in similar proportions. Contrary to the Advanced Paediatric Life Support guidelines many children admitted to PIC for SE receive over two doses, or inadequate doses, of benzodiazepine. There is a risk of respiratory depression following administration of over two doses of benzodiazepine (chi2 = 3.4, p = 0.066). Children with SE admitted to PIC who had prehospital emergency treatment are more likely to receive over two doses of benzodiazepines (chi2 = 11.5, p = 0.001), and to subsequently develop respiratory insufficiency (chi2 = 6.2, p = 0.01). Mortality is low. Further study is required to determine the morbidity associated with SE in childhood requiring intensive care.
Conclusions:
As the risk of respiratory depression is greater with more than two doses of benzodiazepines, clinicians should not disregard prehospital treatment of SE. As pre-PIC treatment of SE is inadequate in many cases, appropriate audit and modifications of standard guidelines are required.
More Related Videos
09:57Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
Published on: September 20, 2024
10:22Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
Published on: December 6, 2016
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:20Seizures l: Introduction
01:22Epilepsy ll: Types
01:13Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
01:30Acute Respiratory Failure-III
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management